Officials with the U.S. Centers for Disease Control and Prevention have confirmed Zika infections among nine pregnant American women, and are investigating 10 more reported cases.

Among the nine, two of the women miscarried early in their pregnancies, the CDC reported Friday. Two more chose to terminate the pregnancies, including one woman who learned, at 20 weeks, that the fetus appeared to have severe brain abnormalities.

Three more have given birth. Two of those babies were born healthy, while the third has severe microcephaly. In that case, testing found evidence of Zika virus infection in the mother’s amniotic fluid.

The final two pregnancies are continuing.

The two healthy babies were born to mothers who reported Zika virus symptoms in their second or third trimesters.

The baby with microcephaly was born to a mother who noticed Zika symptoms in her first trimester. The women who experienced miscarriages or who chose terminations also noticed Zika symptoms in their first trimesters.

All nine women reported at least one of the four most commonly observed symptoms of Zika infection: fever, rash, an eye infection called conjunctivitis, or joint pain. All the women reported a rash, and most had at least one other symptom.

All the women became infected while travelling or living in South America, the Caribbean, or Polynesia.

Zika normally causes mild illness or no symptoms in most people. But health officials around the world are investigating a possible link between Zika infections in pregnancy and the microcephaly birth defect.